Otology/Neurotology

Management of mal de debarquement syndrome as vestibular migraines

Yaser Ghavami MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Yarah M. Haidar MD,

Yarah M. Haidar MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Kasra N. Ziai MD,

Kasra N. Ziai MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Omid Moshtaghi BS,

Omid Moshtaghi BS

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Jay Bhatt MD,

Jay Bhatt MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Harrison W. Lin MD,

Harrison W. Lin MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Hamid R. Djalilian MD,

Corresponding Author

Hamid R. Djalilian MD

[email protected]

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A.

Send correspondence to Hamid R. Djalilian, MD, Director, Division of Otology, Neurotology and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California Irvine, Otolaryngology-5386, 19182 Jamboree Road, Irvine, CA 92697. E-mail: [email protected]Search for more papers by this author

Yaser Ghavami MD,

Yaser Ghavami MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Yarah M. Haidar MD,

Yarah M. Haidar MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Kasra N. Ziai MD,

Kasra N. Ziai MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Omid Moshtaghi BS,

Omid Moshtaghi BS

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Jay Bhatt MD,

Jay Bhatt MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Harrison W. Lin MD,

Harrison W. Lin MD

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

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Hamid R. Djalilian MD,

Corresponding Author

Hamid R. Djalilian MD

[email protected]

Division of Otology, Neurotology, and Skull Base Surgery, Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, Irvine, California, U.S.A.

Department of Biomedical Engineering, University of California, Irvine, Irvine, California, U.S.A.

First published: 12 October 2016

https://doi.org/10.1002/lary.26299

Citations: 34

Financial Disclosure: The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objective

Mal de debarquement syndrome (MdDS) is a balance disorder that typically starts after an extended exposure to passive motion, such as a boat or plane ride. Management is typically supportive (e.g. physical therapy), and symptoms that persist beyond 6 months have been described as unlikely to remit. This study was conducted to evaluate the response of patients with MdDS to management with migraine prophylaxis, including lifestyle changes and medical therapy.

Study Design

Prospective review.

Setting

Ambulatory setting at a tertiary care medical center.

Methods

Clinical history, detailed questionnaires, and audiograms were used to diagnose patients with MdDS. Those patients with the diagnosis of the MdDS were placed on our institutional vestibular migraine management protocol. Treatment response was assessed with a quality-of-life (QOL) survey and visual analog scale.

Results

Fifteen patients were diagnosed with MdDS, with a predominance of females (73%) and a mean age of 50 ± 13 years. Eleven patients (73%) responded well to management with a vestibular migraine protocol, which included lifestyle changes, as well as pharmacotherapy with verapamil, nortriptyline, topiramate, or a combination thereof. In comparison, a retrospective control group of 17 patients demonstrated a lower rate of improvement when treated with vestibular rehabilitation and physical therapy.

Conclusion

Management of MdDS as vestibular migraine can improve patients' symptoms and increase the QOL. Nearly all the patients suffering from MdDS had a personal or family history of migraine headaches or had signs or symptoms suggestive of atypical migraine.

Level of Evidence

4 Laryngoscope, 127:1670–1675, 2017

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Citing Literature

Volume127, Issue7

July 2017

Pages 1670-1675

Management of mal de debarquement syndrome as vestibular migraines

Abstract

Objective

Study Design

Setting

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Management of mal de debarquement syndrome as vestibular migraines

Abstract

Objective

Study Design

Setting

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

Information